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. 2025 Jun 21:21:100602.
doi: 10.1016/j.ijcchd.2025.100602. eCollection 2025 Sep.

Trends in mortality from pulmonary hypertension amongst population with congenital heart disease in the United States from 1999 to 2020: A CDC WONDER analysis

Allahdad Khan  1 , Tehreem Asghar  2 , Kumail Mustafa Ali  3 , Muhammad Saeed  4 , Saniya Ishtiaq  5 , Fatima Ashfaq  1 , Jamil Nasrallah  6 , Laiba Yumn  1 , Usman Ali Akbar  7 , Peter Collins  8 , Raheel Ahmed  8
Affiliations

Trends in mortality from pulmonary hypertension amongst population with congenital heart disease in the United States from 1999 to 2020: A CDC WONDER analysis

Allahdad Khan et al. Int J Cardiol Congenit Heart Dis. .

Abstract

Background: Congenital heart disease (CHD) is an umbrella term describing a variety of structural cardiac malformations at birth. CHD affects approximately 1 % of live births, generating a large adult population with these abnormalities. Pulmonary hypertension (PH) in patients with adult CHD is heterogeneous, based on the type of defect and associated conditions, but is a known cause of adverse outcome.

Method: We retrieved death certificate data from the CDC-WONDER database using ICD codes (I27.0, I27.2, I27.8, and I27.9., and Q20-26). Crude mortality rates (CMRs) and age-adjusted mortality rates (AAMRs) per 100,000 persons were calculated. Temporal trends were examined using the annual percent change (APC) and average annual percent change (AAPC) determined by Joinpoint regression.

Result: From 1999 to 2020, an overall declining pattern was observed in the mortality rate. Men and women with congenital heart disease and pulmonary hypertension in the U.S. experienced a statistically significant decline in mortality rates. In terms of races, among White individuals, the decline was the most pronounced. All four U.S. census regions experienced statistically significant declines in mortality due to pulmonary hypertension among individuals with congenital heart disease. The rate of decline was steeper in rural areas compared to urban ones.

Conclusion: This study highlights that previously implemented targeted interventions significantly contributed to the reduction of mortality amongst patiemnts with congenital heart disease and pulmonary hypertension in the U.S. Still improvements are required in certain areas, including female gender, Hispanic or Latino, and the Northeast and West regions.

Keywords: CDC WONDER; Congenital heart disease; Mortality; Pulmonary hypertension.

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Conflict of interest statement

The authors declare the following financial interests/personal relationships which may be considered as potential competing interests:Raheel Ahmed reports was provided by Imperial College London National Heart and Lung Institute. If there are other authors, they declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

Figures

Image 1
Graphical abstract
Fig. 1
Fig. 1
Age-adjusted mortality rates (AAMRs) per 100,000 individuals stratified by sex/gender in the United States, 1999 to 2020.
Fig. 2
Fig. 2
Age-adjusted mortality rates (AAMRs) per 100,000 individuals stratified by race/ethnicity in the United States, 1999 to 2020.
Fig. 3
Fig. 3
Age-adjusted mortality rates (AAMRs) per 100,000 individuals stratified by census region in the United States, 1999 to 2020.
Fig. 4
Fig. 4
Age-adjusted mortality rates (AAMRs) per 100,000 individuals stratified by urbanization in the United States, 1999 to 2020.
Fig. 5
Fig. 5
Age-adjusted mortality rates (AAMRs) per 100,000 individuals stratified by state in the United States, 1999 to 2020.
See this image and copyright information in PMC

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